Provider Demographics
NPI:1346580818
Name:GLASSON, MELISSA LEIGH (LSW)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:LEIGH
Last Name:GLASSON
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:MISS
Other - First Name:MELISSA
Other - Middle Name:LEIGH
Other - Last Name:SHIELDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:2434 S EASON BLVD
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38804-6942
Mailing Address - Country:US
Mailing Address - Phone:662-844-1717
Mailing Address - Fax:662-680-6416
Practice Address - Street 1:2434 S EASON BLVD
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38804-6942
Practice Address - Country:US
Practice Address - Phone:662-844-1717
Practice Address - Fax:662-680-6416
Is Sole Proprietor?:No
Enumeration Date:2013-02-21
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker